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Contextualizing social network influences on substance use among high risk adolescents

CONTEXTUALIZING SOCIAL NETWORK INFLUENCES ON
SUBSTANCE USE AMONG HIGH RISK ADOLESCENTS
by
Patchareeya Pumpuang Kwan
___________________________________________________________________
A Dissertation Presented to the
FACULTY OF THE USC GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(PREVENTIVE MEDICINE: HEALTH BEHAVIOR)
May 2010
Copyright 2010 Patchareeya Pumpuang Kwan

Social network influences predict how we act and behave. Most people tend to comply with social norms and beliefs so that they are accepted by society. Characterized by physical, emotional and mental changes, adolescents are no different when it comes to social conformity. Peer influences become a strong predictor of how adolescents act and behave. Many of these individuals behave in ways that are encouraged and acceptable by peers despite the delinquent nature of the behavior. The purpose of this dissertation is to understand adolescent social influence and contextualized social networks as it relates to drug use.; The purpose of the first analysis, depicted in chapter 2, is to examine intentions as a mediator of the relationship between friend approval of drug use and drug use. Data on drug use was examined in roughly 400 alternative high school students. Best friends’ approval of drug use was used as the independent variable with use of alcohol, marijuana, cigarette, hard drugs and a composite drug use score were used as the dependent variables. Drug use intentions is the mediator variable of interest. Mixed model logistic regression was used to conduct mediation analysis as described in Baron and Kenny, 1986. Results of this analysis showed that behavioral intentions fully mediated the relationship between best friend’s approval and cigarettes and marijuana use. Intentions partially mediated the relationship between approval and hard drug use. This is consistent with past research and theoretical models such as the Theory of Reasoned Action.; In chapter 3 we will look at the second set of analysis concerning bilingualism as a possible protective factor against adolescent drug use. Logistic regression using school and classroom as the random effect was conducted on approximately 880 male and female students in alternative high schools. Outcome variables of interest were baseline use of alcohol, marijuana, cigarette, hard drugs and a composite drug use variable. Age, gender, ethnicity, SES, acculturation and number of best friends were used as controlled variables. Individual bilingualism scores and best friends’ bilingualism scores (i.e. the level of bilingualism of the individual’s five best friends) were the predictor variables of interest. Results indicated that among males and females, best friends’ bilingualism decreased the probability of alcohol, marijuana and cigarette use. Sub-group analysis by sex reveals that among males, bilingualism was not associated with drug use but among females best friend bilingualism was associated with decreasing the probability of alcohol, marijuana, cigarettes and all drug use. These findings suggest differences in how male and female students are influenced by their bilingual peers.; Chapter 4 examines the association between peer leader drug use behaviors and the behaviors of the individual students. Logistic regression using school, classroom and network group as the random effects was used to analyze post intervention drug use behaviors of approximately 525 male and female students. Students were randomized into three groups – control, standard curriculum or networked curriculum where students were grouped according to self reported group leader nominations. Peer leader drug usage behavior was the independent variable of interest. Individual drug use was the outcome being examined. Results showed that among the combined male and female group, there was no significant association between peer leader use and post-test drug use. Among males only, peer leader use at baseline was positively associated with alcohol use and peer leader use at post-test was positively associated with hard drug use. Both of these associations were moderated by the network condition (i.e. the interaction term was significant). Among females only, peer leader use at post-test was negatively associated with marijuana and cigarette use at post-test. Again, both were moderated by the network condition. These findings suggest that having peer leaders in the network condition decreased the odds of marijuana and cigarette use among female students. The opposite effect was found in males. This lends credence to the idea that males and females interact differently when placed in peer groups.

CONTEXTUALIZING SOCIAL NETWORK INFLUENCES ON
SUBSTANCE USE AMONG HIGH RISK ADOLESCENTS
by
Patchareeya Pumpuang Kwan
___________________________________________________________________
A Dissertation Presented to the
FACULTY OF THE USC GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(PREVENTIVE MEDICINE: HEALTH BEHAVIOR)
May 2010
Copyright 2010 Patchareeya Pumpuang Kwan